Individual
LAQUESHA LARENDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
165 BROWNLEE CIR, TIFTON, GA 31794-1651
(229) 325-5384
Mailing address
165 BROWNLEE CIR, TIFTON, GA 31794-1651
(229) 325-5384
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN207444
GA
372600000X
Adult Companion
RN207444
GA
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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